From the Research
Antibiotics for Dental Abscess
- The use of antibiotics for dental abscess is generally recommended in cases of systemic involvement, such as fever or lymphadenopathy, or in immunocompromised patients 1, 2, 3.
- In cases of localized acute apical abscess, antibiotics are not considered to be of additional benefit, and drainage of the abscess through a pulpectomy or incision and drainage is the recommended treatment 1.
- Penicillin G, penicillin V, or amoxicillin are commonly recommended as first-line systemic antimicrobial agents for the treatment of odontogenic infections, with amoxicillin-clavulanate, cefuroxime, or penicillin and metronidazole as second-line options 2.
- Clindamycin is recommended for patients allergic to penicillin 2.
- A study comparing amoxicillin and cefalexin found that both antibiotics were effective in reducing the duration of clinical symptoms in patients with acute odontogenic abscess, with cefalexin showing a slightly higher antibiotic susceptibility rate 4.
- There is currently no clinical evidence to support or refute the use of antibiotics in children with an odontogenic abscess in the primary dentition without signs of local spread or systemic involvement 5.
Specific Antibiotics
- Azithromycin has been shown to be effective in one open-label study, with a result favoring azithromycin over co-amoxiclav 1.
- Amoxicillin and cefalexin have been shown to be effective in reducing the duration of clinical symptoms in patients with acute odontogenic abscess 4.
- Metronidazole is recommended for use in combination with penicillin or amoxicillin for the treatment of periodontal infections 2.
- Tetracycline, augmentin, or metronidazole and amoxicillin are recommended for the treatment of aggressive periodontitis 2.